Provider Demographics
NPI:1083485478
Name:CHM DIALYSIS
Entity Type:Organization
Organization Name:CHM DIALYSIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RYON
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:BSN RN
Authorized Official - Phone:817-408-0875
Mailing Address - Street 1:PO BOX 383
Mailing Address - Street 2:
Mailing Address - City:STERLING CITY
Mailing Address - State:TX
Mailing Address - Zip Code:76951-0383
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:440 COBIA DR STE 1004
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-6914
Practice Address - Country:US
Practice Address - Phone:817-408-0875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment